Effectiveness of electromyography guided botulinum toxin injection and dextrose prolotherapy in recurrent TMJ dislocation (radiographic and clinical study)

Objectives: This study was conducted to assess effectiveness of dextrose prolotherapy, Electromyography (EMG) Guided Botulinum Toxin – A (BTX-A) Injection, and combination between them   in treatment of recurrent TMJ Dislocation cases. Subjects and methods: This current study was carried out on 60 adult patients suffering from recurrent TMJ Dislocation. The patients divided equally into three groups, Group I: 20 patients were treated with EMG guided BTX-A injection. Group II: 20 patients were treated with dextrose prolotherapy. Group III: 20 patients were treated with combination of EMG guided BTX-A injection and dextrose prolotherapy. The clinical evaluation preoperatively and postoperatively (at 1week , 3 months , 6 months)  included visual analog scale of TMJ pain, maximum mouth opening (MMO), and frequency of luxations . Radiographic evaluation using MRI was done preoperatively, and at 6 months.  The collected data were then statistically analyzed. Results: best results were recorded in group III compared with other groups; at all intervals of study with significant reduction of pain score, and frequency of luxations beside to improvement of MMO measurements. Conclusion: the combination of EMG guided BTX-A injection and dextrose prolotherapy is a promising treatment in recurrent TMJ dislocation cases.&nbsp